Thursday, March 12, 2009

My previous post was about the recent kidney exchange innovation by the Alliance for Paired Donation, just reported in today's issue of the New England Journal of Medicine. That NEJM immediately attracted some press, and in this post I consider the role that the NEJM's press embargo policy might play in generating news stories about some of the articles they publish.

The press policy of the NEJM is communicated to authors as follows (emphasis added):"Your Brief Report will appear in the March 12, 2009 issue of the New England Journal of Medicine (NEJM). This information is confidential. There is a press embargo on the contents of the issue until 5:00 PM ET on Wednesday March 11, 2009. On Friday, March 6, 2009 the content of the March 12, 2009 issue will made available to reporters who have agreed to respect our embargo. "

That is, a week before publication, the NEJM makes the forthcoming issue available to reporters who have agreed not to write about it until a specified time the next week.

To better understand how this kind of policy plays out, I asked a public relations person about the NEJM and their policy, and got the following reply:"...they have a reputation of being one of the best PR machines there is. Their embargo is one of the toughest on the planet as well; reporters and any others who violate it are dead for the rest of their lives in getting information on future NEJM articles. Anyone in the medical writing community knows and fears this."

At 9 pm on March 11, four hours after the embargo ended, here's what a Google news search for "kidney exchange" looked like (note the link to "all 217" news articles):

The first of these articles, in the Globe, was written by a reporter who talked to several of the participants, concentrating on those in Boston (which is where the economists on the team all reside, and also where another kidney exchange program, the New England Program for Kidney Exchange was started). The second (in Science Daily) is a press release issued by Boston College (where my economist colleagues Tayfun Sonmez and Utku Unver both teach). Some of the remaining stories have original content, but many are largely if not completely taken from some of the original reporting and press material. (I like the story that ran in the Washington Post, because it has a slideshow that shows off Mike Rees, the innovative--and apparently good looking--surgeon who is the lead author of the NEJM article, and a figure of emerging importance in the national discussion of kidney exchange).

So...I've written a lot of articles that attract little or no press, and certainly not a flood in a few hours. While kidney exchange is undoubtedly a subject with wider popular appeal than, say, the lattice structure of fixed points, I'm guessing that the NEJM's embargo policy plays at least some role (recall the comment that they are one of the best PR machines...). Here are three hypotheses--one psychological and two economic--about why the embargo might matter.

Hypothesis 1 (behavioral/psychological): telling reporters they can't publish before 5PM Wednesday makes them want to write about the story more...

Hypothesis 2. (coordination equilibrium): telling reporters that no one can publish before 5PM Wednesday reassures them that the time they put into the story won't be wasted, they won't be scooped by someone else who finishes their story earlier.

Hypothesis 3. (common value/winner's curse): in the absence of an embargo, a reporter tempted to try to write the first story might be worried that the absence of previous stories means that the subject isn't as interesting as it looks, won't be picked by editors, etc. To put it another way, whoever writes the first story might be (like the high bidder in a common value auction) the person who thought it was the most interesting, and the fact that no one else agreed how interesting it was might mean that he has overestimated its value. But, when there is an embargo, this kind of negative selection can't be going on; no one else could have published earlier, so the absence of earlier stories isn't a negative signal.

(Blogs, incidentally, seem to work on a different schedule; here are the March 12 takes by Steve Levitt and by Tim Harford on the original story...)

what about reputation? if you know that the journal reliably publishes important studies and gives you the time to write your article, then it's a no-brainer to cover it.

my guess is, the embargo isn't a gimmick, but a way to ensure people don't make mistakes. (statistics agencies do the same.) those errors would be a cost, either because they would have to spend time explaining to the next reporter not only what the study shows, but also why the other guy was wrong, or because they just dislike mistakes as part of their science-oriented preferences.

there might also be legal issues -- some of those studies may affect company stocks and it's important to make sure everything is on the up and up.